Dean College Sports Medicine Department

Concussion Policy 2017

Definition

A concussion is a brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces. Any athlete presenting with concussion like symptoms will be evaluated by the covering licensed certified athletic trainer. A referral to team physician or neuropsychologist may be warranted, if a concussion is suspected and the athlete presents with any following:

-loss of consciousness (> 1 min), amnesia

-concussive convulsions

-vomiting

comorbidities/premorbidities such as migraine, depression, or other mental health disorders; attention-deficit hyperactivity disorder; learning disabilities; sleep disorder

-currently taking psychoactive drugs or anticoagulants

-prior history of 3 concussions or more

If an athlete is evaluated by a physician outside of Dean College, they must be evaluated by a physician who is trained in the evaluation and management of concussions and provide the licensed certified athletic trainer with a signed note of diagnosis and/or clearance from the physician prior to returning to sport. If an athlete sees a physician for a second opinion to challenge the licensed certified athletic trainer evaluation of a concussion, the physician must present a note of diagnosis explaining the diagnosis to the licensed certified athletic trainer and team physician. The sport athlete will then follow the prescribed graduated return-to-sport protocol supervised by the licensed certified athletic trainer.

Academic Support During Recovery

The athlete will work with his/her advisor, sport coach, and licensed certified athletic trainer when making modifications to classroom participation and class work as needed. Modifications may include :

-excused absence from class

-rest periods during the school day

-extension of assignment deadlines

-postponement or staggering of tests

-excuse from (or unweight) specific tests and assignments

-extended testing time

-accommodation for light or noise sensitivity

-use of a reader (or recorded books) for assignments and testing

-use of a note take or scribe

-use of a smaller, quieter examination room

-temporary assistance of a tutor

Graduated Return-to-Play Protocol

The following is a stepwise progression for all athletes who sustain a concussion will follow and is based upon recommendations from the National Athletic Training Association consensus statement following the 4th International Conference on Concussion in Sport, Zurich of November 2012. The sport athlete will continue to proceed to the next level if asymptomatic at the current level for 24 hours. If any post-concussion symptoms occur while in the stepwise program, the dance athlete will drop back to the previous asymptomatic level and try to progress again after a further 24-hour period of rest has passed. Modifications to this protocol may be made solely by the licensed certified athletic trainer, overseeing sports medicine physician, or neuropsychologist.

Rehabilitation Stage Functional Exercise at Each Stage of Rehabilitation Objective(s) of Each Stage

1. No activity Symptom-limited physical and cognitive rest Recovery

2. Light aerobic exercise Walking, elliptical, or stationary cycling, keeping intensity <70% of max heart rate, no resistance training. Approx 15 minutes total activity Increase heart rate

3. Sport specific warm up exercises Sport warm up, approx 30 minutes total activity Add movement

4. Sport Specific Movement/Technique Progression to more complex sport movement, light jumping. Approx 1 hour of total activity Exercise, coordination, and cognitive load

5. Full Sport Participation After medical clearance, participation in full dance movement Restore confidence and assessment of functional skills by ATC

McMrory et al. Consensus statement on concussion in sport: The 4th international conference on concussion in sport, zurich, november 2012. J of Athletic Training. 2013;48(4):554-575.

McGrath N. Supporting the student-athlete?s return to the classroom after a sport-related concussion. J of Athletic Training. 2010;45(5):492-498.